Columnist: ACA stinks, and bickering blocks improvement
Today’s column may get me banned from my favorite coffee shop in Carbondale, but, oh well, the library is open till 8, and late fees are cheaper than coffee.
The Affordable Care Act is not working.
Of course, pointing that out has become akin to the Emperor’s New Clothes of liberalism. Everyone is too embarrassed to admit that they just paid a ton of money to a couple hundred con artists to parade their well-intentioned ideals down Main Street in the buff.
After spending another five hours on the phone with Connect for Health CO since my last column, I have had time and background music to consider what is wrong with the state system. I again investigated Ballot Measure 69, aka “Universal health care,” aka “single-payer,” but I can no longer justify giving our state government more money when it is already bungling so spectacularly what it already has.
I spoke with several experts about House Bill 16-1336, which would start the process of removing the arbitrary price differences between regions within the state. While I fully support this, my Swifty niece would remind me that “Band-Aids don’t fix bullet holes.”
So, although it was not originally my intention with this column, I had to look nationally for a solution. And the culprit soon becomes apparent.
The ACA is not helping America.
In fact, the partisan controversy and name-calling that surround this legislation are doing a wonderful job of distracting us and our money from the changes that actually need to occur in order to see more reasonable health-care costs.
We often hear about the universal health care of countries like Norway and Sweden or even the two-tier systems available in Australia and France as proof of success. But the differences between our country’s infrastructure, government and population and theirs are too significant to ignore.
And until we identify the root causes of our obscene costs within those differences, we are comparing apples to kumquats when we say, “Look how well it works in (fill in the blank).”
So here are three very basic differences to consider.
1. In America, doctors often practice defensive medicine against malpractice suits.
According to a study published in 2010 by Laura Hermer and Howard Brody, defensive medicine is defined as “…the ordering of treatments, tests and procedures primarily to help protect the physician from liability rather than to substantially further the patient’s diagnosis or treatment.” One example, of many, that they provide is how in 2008, Massachusetts doctors estimated that “between 20 percent and 30 percent of [diagnostic scans], specialty referrals and consultations were ordered primarily for defensive purposes.”
Not only do these nonessential tests drive up individual and institutional costs, but hospitals and private practices must pay enormous insurance overhead to protect them from potential frivolous malpractice lawsuits. According to another article published in 2013, around 75 percent of doctors face malpractice lawsuits sometime during their career, with a price tag of around $17,000 even for the ones they win.
Because American lawyers rely heavily on contingency fees (or a percentage of the monetary win), they have every reason to ask for enormous amounts for their clients. These payouts then become normalized, and the price jumps again.
2. Pharmaceutical companies spend millions every year for political clout.
In the 2012 election, companies that identify as pharmaceutical or medical research spent $51 million to support their chosen candidate. This money allows them to sway legislation and create perks for the industry like the ability to monopolize their drug and prevent generics from being developed for up to 20 years; preventing health care providers from purchasing drugs from other countries — even if those drugs pass FDA standard; and preventing Medicare from negotiating the prices of drugs.
Looking at comparison data, name-brand (and many generic) drugs are double what the same pill would cost in other countries — including those that can offer “universal” care for their citizens.
3. American culture idolizes unhealthy lifestyles.
In the five years I have spent teaching at a middle school, I have often seen students walking around with a bag of chips for their lunch, an energy drink for breakfast or a shrug with an “I’m-not-hungry.”
Health education has been required in Colorado only in the last few years, and is not required at all in much of the country. And if we provide the education, unfortunately healthy food still costs about $1.50 more per day more than junk food with high sugars and fats. TVs, iPads and video games are cheaper than baby-sitters, and many families do not have reasonable, safe access to outdoor spaces.
As of last year’s data, the obesity rate in America was around 37 percent. Incomplete BMI metrics notwithstanding, the statistic of 1 in 3 is shocking — or at least it used to be. Countless dangerous and expensive health complications come with poor cholesterol and fatty build-up, so it is no surprise that Americans pay $190.2 billion a year to treat related conditions.
Although on the rise in many other countries, the closest universal-care runner-up is Canada, with obesity rates of 23.5 percent in women and 27.6 percent in men.
None of these flaws is a spackle and paint fix. Money still holds the bullhorn in our country (thank you Citizens United et. al.), and a healthy lifestyle most often takes several generations of retraining.
So let it go. Whether you call it the ACA or Obamacare, whether you blame Republicans for tanking the act with unnecessary addendum tantrums, or the Democrats for rah-rahing an under-researched over-governmented solution, any effort to sustain or even reform the ACA is misdirected.
Instead, we need to make positive growth where we can and stop grandstanding our blind support or abject loathing with righteous Facebook updates whenever “the other side” makes a mistake.
Lindsay DeFrates lives and teaches in Carbondale. She writes and rafts, grades and goes down slides, sometimes not in that order. Her column appears on the first Tuesday of the month.
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